内镜下泪囊鼻腔吻合改良术式的疗效分析  

Analysis of the efficacy of modified endoscopic dacryocystorhinostomy

作　　者：李沙 陈琳[1] 张咏 张将[2] Li Sha;Chen Lin;Zhang Yong;Zhang Jiang(Wuhan Aier Hankou Eye Hospital,Wuhan 430024,China;Wuhan Aier Eye Hospital,Wuhan 430063,China)

机构地区：[1]武汉爱尔眼科医院汉口医院,430024 [2]武汉爱尔眼科医院,430063

出　　处：《中华眼外伤职业眼病杂志》2020年第9期665-669,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：湖北省武汉市医学科研面上重点项目(WX19A03);湖北省卫生健康委员会联合基金项目(WJ2019H318)。

摘　　要：目的评估改良的涂刷式膨胀海绵填塞法内镜下泪囊鼻腔吻合术的治疗效果.方法前瞻性病例对照研究.以2017年12月到2019年3月于武汉爱尔眼科医院汉口医院接受内镜下泪囊鼻腔吻合术的慢性泪囊炎256例(286眼)作为研究对象,随机分为两组,对照组111例(125眼)术中使用常规膨胀海绵填塞法;试验组145例(161眼)术中使用微纤维止血胶原涂刷式膨胀海绵填塞法.术后随访6个月,比较两组疗效.结果术后6个月,对照组治愈率为72.00%(90/125),好转率为21.60%(27/125),无效率为6.40%(8/125).试验组治愈率为83.85%(135/161),好转率为11.18%(18/161),无效率为4.97%(8/161).两组患者治疗效果对比,差异有统计学意义(χ^2=5.459,P=0.019).结论改良的涂刷式膨胀海绵填塞法能够提高内镜下泪囊鼻腔吻合术的效果.Objective To evaluate the efficacy of modified brushing expansive sponge filling method in endoscopic dacryocystorhinostomy.Methods This was a prospective case-control study.A total of 286 eyes of 256 cases with chronic dacryocystitis,who were treated with endoscopic dacryocystorhinostomy(EN-DCR)from Dec.2017 to Mar.2019 in Wuhan Aier Hankou Eye Hospital were analyzed.All cases were divided randomly into two groups.The control group,125 eyes of 111 cases,were treated with conventional expansive sponge filling method in EN-DCR.The clinical trial group,161 eyes of 145 cases,were treated with microfibrillar collagen hemostat in brushing expansive sponge filling method in EN-DCR.All patients were followed up for 6 months postoperatively,and the efficacy were compared between the two groups.Results At 6 months after surgery,the cure rate of the control group was 72.00%(90/125),the improvement rate was 21.60%(27/125),and the ineffective rate was 6.40%(8/125).In the trial group,the cure rate was 83.85%(135/161),the improvement rate was 11.18%(18/161)and the ineffective rate was 4.97%(8/161).The difference in the efficacy between the two groups was statistically significant(χ^2=5.459,P=0.019).Conclusion The modified brushing expansive sponge filling method can improve the prognosis of endoscopic dacryocystorhinostomy.

关 键 词：填塞 膨胀海绵 涂刷 吻合术 泪囊鼻腔 内镜下 泪囊炎 慢性 

分 类 号：R779.6[医药卫生—眼科]